Provider Demographics
NPI:1871290692
Name:CASSOLA, MARIA (APRN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CASSOLA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MARIA DE LA CARIDAD
Other - Middle Name:
Other - Last Name:CASSOLA VALDES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15865 NW 90TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33018-6355
Mailing Address - Country:US
Mailing Address - Phone:786-474-2745
Mailing Address - Fax:
Practice Address - Street 1:15865 NW 90TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33018-6355
Practice Address - Country:US
Practice Address - Phone:786-474-2745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11024274363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily